Children and Cow‘s Milk: How much should they drink?


29. 05. 2014

While some parents make efforts to give milk to their children when they reach three years of age, others incorporate cow’s milk already in the first year of a child’s life. So what do doctors recommend? As a child gets older another question comes to mind – Is milk a necessary constituent of his/her diet or can it be substituted in any way?

Modern medicine recommends an exclusion of cow’s milk from a child’s nutrition within the first year of life, because it contains too much protein and very few vitamins, especially the vitamin D, that is important for having strong bones. Moreover, cow’s milk contains very little iron. The first four months since birth a baby should feed exclusively on milk, preferably mother’s milk or its substitute also known as infant formula.    

Otherwise and based on doctor’s advice it is possible to choose infant formula for babies with some specific problems: an antireflux with a lower content of lactose, or hypoantigenic milk formula with cleaved protein. There are no benefits of giving hypoallergenic milk to healthy babies. There is no prophylactic effect as such. However, babies who have family history of atopic disease are more in risk of developing allergic reaction. If such baby is not breastfed the use of hypoallergenic formula may delay the occurrence of allergy.  

This information stems from a recently published literature source called Doporučení pracovní skupiny dětské gastroenterologie a výživy České pediatrické společnosti (Working Group Recommendations in Paediatric Gastroenterology and Nutrition by the Czech Paediatric Society) which was issued in April 2014. It is based on the most up-to-date international findings.

If milk then full fat

A baby can drink cow’s milk since the end of his/her second year of life, and full fat is more preferable. But if parents prefer infant formula with a constant level of vitamins, iron and protein, this is not a problem and they may continue to use it. It is advisable to take into account child’s age and body weight.   

In terms of cow’s milk it is better to use organic and to refrain from the long life milk treated by UHT technology. Fresh milk from the machines is not suitable either, because it usually does not undergo pasteurisation process, therefore a risk of listeriosis or tuberculosis is high.

Full fat milk should be given from the second or third year of child’s life. This applies to all other dairy products, because cholesterol is important for children and their development. Besides, we now know that very few of the milk components are harmful.

After three years of age parents can integrate even low fat produce as it contains the same amount of calcium. Just beware it is not mixed with starch or sugar, the worse being artificial sweeteners. Skimmed milk is also not suitable as it contains just one and a half percent of fat.

Not milk? Add hard cheese

If a child refuses milk he/she should be encouraged to eat yogurt or hard cheese, but not soft cheese as it contains too much salt of phosphoric acid. Children should refrain from eating Danish blue as well. Those younger than one year should avoid cottage cheese or curd, because it has too much protein that may interfere with kidney function. 

Advantage of hard cheese is that it can be served in many different ways – you can grate it, or cut it into small pieces for finger food. Infants and toddlers find it more fun, they learn to chew, bite, swallow, and these are crucial skills for developing healthy eating habits.

A child should continuously reduce milk input

One-year olds and older should have milk as complementary to their diet and drink approximately 300 to 330 millilitres per day. If a child drinks litre of milk a day, he/she has little space to digest varied food. Often this is because he/she gets milk in a bottle which he/she loves and refuses to abandon.

But in the second or third year of life there is a higher risk of having tooth decay. Moreover, such amount of liquid rich in protein puts strain on kidneys.

If thirsty a child should drink water or other liquid. Milk is more like food. If he/she is used to drink a cocoa, it is best to do it in the morning than in the evening to prevent tooth decay.

Children and adolescents can drink milk for change of their fluid input (as part of breakfast for instance). Proponents of mainstream medicine consider drinking milk in childhood and adolescence as beneficial, for example, it prevents osteoporosis in the future. However, this includes all diary produce. Milk can be substituted by hard cheese, preferably low fat type, it provides sufficient amount of calcium and protein as well.   

It should be mentioned that there are opponents of milk drinking who claim that milk is not suitable for humans, apart from young children. It may be noted that older child who does not drink milk at all must receive an adequate source of calcium which is found in nuts, seeds or fish. In addition, children and adolescents can get protein from meat and pulses.

Barbara Taušová – pediatrician, founder, executive head and director of private family medical center Canadian Medical Care in Pragueowner of a private pediatric office in Prague.


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